Blood test, basic metabolic panel
Facility: Saint John Hospital
Billing Code: 80048 (CPT)
- CPT Billing Code: 80048
- Insurance Median: $9
- Cash Discount Price: $8
- vs. Medicare Baseline: 1.06x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $8.46 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Cigna | $8 | 95% |
| Tricare | $8 | 95% |
| Midland Care Connection | $8 | 95% |
| Medicaid / KanCare | $8 | 95% |
| Medicare (plans) | $8 | 95% |
| Aetna | $8 - $15 | 95% |
| UnitedHealthcare | $8 - $12 | 95% |
| Blue Cross Blue Shield | $9 - $20 | 106% |
| Celtic | $9 - $109 | 106% |
| Kansas Superior Select | $9 | 106% |
| Healthy Blue | $9 | 106% |
| Employer Direct Healthcare | $12 | 142% |
| Well Path | $12 | 142% |
| Corizon | $12 | 142% |
| Naphcare | $13 | 154% |
| Centurion | $13 | 154% |
| Comp Alliance Workers Comp | $17 | 201% |
| Oha Networks | $18 | 213% |
| Worker Compensation | $19 | 225% |
Consumer Guidance & Cost Commentary
For CPT code 80048, a basic metabolic panel, Saint John Hospital in Leavenworth, KS, lists a gross charge of $312.00. While the facility's cash median rate is $8.00, which is significantly lower than the negotiated rates paid by major payers like Celtic ($9.00) and Aetna ($9.00 to $109.00), patients should be aware that insurance plans often result in higher out-of-pocket costs if deductibles are not yet met. The facility's negotiated median rate of $9.00 is higher than the cash price, illustrating that paying cash upfront can sometimes be more economical than relying on insurance reimbursement, particularly for those with high-deductible plans. Additionally, the facility offers a prompt-pay discount, which is a fee reduction typically ranging from 20% to 50% for upfront payments, effectively bypassing the administrative overhead and bad debt risks associated with the insurance billing cycle.
When comparing pricing to federal benchmarks, the facility's Medicare amount of $8.46 serves as the objective baseline for evaluating its rates. The facility's cash rate of $8.00 is slightly below the Medicare benchmark, whereas the gross charge of $312.00 represents a substantial markup. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final invoice. Before scheduling, patients are encouraged to explicitly request self-pay classification and prompt-pay rates to secure the lowest possible price, as